Comparison of prostate MRI-3D transrectal ultrasound fusion biopsy for first-time and repeat biopsy patients with previous atypical small acinar proliferation
| Autor: | Ashley Mercado, Aaron D. Ward, Jonathan I. Izawa, Lori Gardi, Aaron Fenster, David Tessier, Jonathan Mandel, Derek W. Cool, Cesare Romagnoli, Joseph L. Chin |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Atypical small acinar proliferation Prostate biopsy medicine.diagnostic_test business.industry Urology Ultrasound 030232 urology & nephrology Cancer Magnetic resonance imaging medicine.disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Oncology Prostate 030220 oncology & carcinogenesis Biopsy medicine Adenocarcinoma Radiology business Original Research |
| Zdroj: | Canadian Urological Association Journal. 10:342 |
| ISSN: | 1920-1214 |
| DOI: | 10.5489/cuaj.3831 |
| Popis: | Introduction: This study evaluates the clinical benefit of magnetic resonance-transrectal ultrasound (MR-TRUS) fusion biopsy over systematic biopsy between first-time and repeat prostate biopsypatients with prior atypical small acinar proliferation (ASAP).Methods: 100 patients were enrolled in a single-centre prospective cohort study: 50 for first biopsy, 50 for repeat biopsy with prior ASAP. Multiparameteric magnetic resonance imaging (MP-MRI) and standard 12-core ultrasound biopsy (Std-Bx) were performed on all patients. Targeted biopsy using MRI-TRUS fusion (Fn-Bx) was performed f suspicious lesions were identified on the prebiopsyMP-MRI. Classification of clinically significant disease was assessed independently for the Std-Bx vs. Fn-Bx cores to compare the two approaches.Results: Adenocarcinoma was detected in 49/100 patients (26 first biopsy, 23 ASAP biopsy), with 25 having significant disease (17 first, 8 ASAP). Fn-Bx demonstrated significantly higher per-core cancer detection rates, cancer involvement, and Gleason scores for first-time and ASAP patients. However, Fn-Bx was significantly more likely to detect significant cancer missed on Std-Bx for ASAP patients than first-time biopsy patients. The addition of Fn-Bx to Std-Bx for ASAP patients had a 166.7% relative risk reduction for missing Gleason ≥ 3 + 4 disease (number needed to image with MP-MRI=10 patients) compared to 6.3% for first biopsy (number to image=50 patients). Negative predictive value of MP-MRI for negative biopsy was 79% for first-time and 100% for ASAP patients, with median followup of 32.1 ± 15.5 months.Conclusions: MR-TRUS Fn-Bx has a greater clinical impact for repeat biopsy patients with prior ASAP than biopsy-naïve patients by detecting more significant cancers that are missed on Std-Bx. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|